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Biomedical subjects

W Leslie

Publications and source records attributed to W Leslie.

16 recordsLinked to original sources
PubMed2002

Standards and guidelines for performing central dual X-ray densitometry from the Canadian panel of International Society for Clinical Densitometry.

The International Society for Clinical Densitometry (ISCD) is a multidisciplinary nonprofit global organization formed to ensure excellence in densitometry imaging, interpretation, and application. The Canadian panel of the ISCD represents ISCD in Canada and oversees Canadian bone densitometry certification programs. The standards of care from the Canadian panel of the ISCD have been developed in order to establish the minimum level of acceptable performance for the practice of bone densitometry in Canada. A variety of techniques are available for skeletal assessment of bone mineral density, which vary in accuracy, precision, and clinical utility as well as availability. This article focuses on central dual X-ray absorptiometry in adults and does not address densitometry in the pediatric population. Other technologies will be addressed in a subsequent article.

Absorptiometry, Photon↗
PubMed2002

Standards and guidelines for performing central dual X-ray densitometry from the Canadian Panel of International Society for Clinical Densitometry.

The International Society for Clinical Densitometry (ISCD) is a multidisciplinary nonprofit global organization formed to ensure excellence in densitometry imaging, interpretation, and application. The Canadian panel of the ISCD represents ISCD in Canada and oversees Canadian bone densitometry certification programs. The standards of care from the Canadian panel of the ISCD have been developed in order to establish the minimum level of acceptable performance for the practice of bone densitometry in Canada. A variety of techniques are available for skeletal assessment of bone mineral density, which vary in accuracy, precision, and clinical utility as well as availability. This article focuses on central dual X-ray absorptiometry in adults and does not address densitometry in the pediatric population. Other technologies will be addressed in a subsequent article.

Absorptiometry, Photon↗
PubMed2000

The incidence of fracture among patients with inflammatory bowel disease. A population-based cohort study.

BACKGROUND: The clinical significance of the high prevalence of osteopenia in inflammatory bowel disease is unclear. OBJECTIVE: To determine whether persons with inflammatory bowel disease have increased incidence of fracture. DESIGN: Population-based matched cohort study. SETTING: Manitoba, Canada. PATIENTS: Patients with inflammatory bowel disease in the University of Manitoba IBD Database (n = 6027) were matched to 10 randomly selected persons in the general population without inflammatory bowel disease (n = 60 270) by year, age, sex, and postal area of residence. MEASUREMENTS: The incidence of hospitalization for hip fracture was determined on the basis of hospital discharge abstracts. Outpatient medical billing records and hospital discharge abstracts were used to calculate the incidence of spine, rib, and forearm fractures. Rates were calculated on the basis of person-years of follow-up for 1984 to 1997. RESULTS: Persons with inflammatory bowel disease had significantly increased incidence of fractures at the spine (incidence rate ratio [IRR], 1.74 [95% CI, 1.34 to 2.24]; P < 0.001), hip (IRR, 1.59 [CI, 1.27 to 2.00]; P < 0.001), wrist/forearm (IRR, 1.33 [CI, 1.11 to 1.58]; P = 0.001), and rib (IRR, 1.25 [CI, 1.02 to 1.52]; P = 0.03) and of any of these fractures (IRR, 1.41 [CI, 1.27 to 1.56]; P < 0.001). CONCLUSION: The incidence of fracture among persons with inflammatory bowel disease is 40% greater than that in the general population.

Adult↗
PubMed1999

Intravenous pamidronate attenuates bone density loss after acute spinal cord injury.

OBJECTIVE: To compare the effects of a 6-month treatment with intravenous pamidronate (30-mg infusion once per month) to conventional rehabilitation without pamidronate on bone density of the spine and leg bones and on the excretion rate of N-telopeptide, a urinary marker of bone catabolism, in acutely spinal cord injured patients. DESIGN: A nonrandomized control trial in which 24 spinal cord injured subjects entered the study within 6 weeks of their injury. Fourteen subjects received pamidronate; 10 did not. OUTCOME MEASURES: Bone density measurements by dual x-ray absorptiometry were performed before the initial treatment (within 6 weeks of the injury) and at 3, 6, and 12 months postinjury and was the primary efficacy parameter. Urine for N-telopeptide levels was the secondary efficacy parameter. RESULTS: After acute spinal cord injury, patients treated with intravenous pamidronate had significantly less bone density loss compared with those who did not receive pamidronate (parametric ANOVA, p<.02). Also, ambulatory subjects had significantly less bone density loss over the study period (p<.05) than nonambulatory subjects. In general, a high excretion level of the urinary bone-breakdown product N-telopeptide was found before intravenous pamidronate treatment, followed by a dramatic reduction in excretion after pamidronate treatment. Ambulatory subjects excreted significantly less N-telopeptide than motor-complete subjects at all time points. CONCLUSION: Intravenous pamidronate treatment and ambulatory ability in the first 6 months after an acute spinal cord injury prevents bone density loss.

Acute Disease↗
PubMed1998

Localization of a presumed catecholamine-secreting glomus tumor by 123I-metaiodobenzyl guanidine (MIBG) single photon emission computed tomography (SPECT) scanning.

We present an unusual case of a 41-year-old woman with a known glomus tumor, an adrenal mass, hypertension, and elevated catecholamines. The glomus tumor was shown to be the site of excessive catecholamine production in what we believe to be one of the few descriptions of 123I-metaiodobenzylguanidine (MIBG) scanning for this uncommon tumor. The diagnostic difficulties of such a case are discussed. A literature review of catecholamine-secreting glomus tumors and a systematic approach to catecholamine-secreting tumor localization in such patients is presented. Therapeutic options of surgery, radiation therapy, and embolization are reviewed. We conclude that the management of patients with functioning glomus tumors needs to be individualized. A careful, systematic approach is required if needless surgery is to be avoided. Further, the use of 123I-MIBG scanning deserves consideration to help localize catecholamine production in such patients.

3-Iodobenzylguanidine↗
PubMed1997

Effect of socioeconomic group on incidence of, management of, and survival after myocardial infarction and coronary death: analysis of community coronary event register.

OBJECTIVE: To investigate the effect of socioeconomic group (with reference to age and sex) on the rate of, course of, and survival after coronary events. DESIGN: Community coronary event register from 1985 to 1991. SETTING: City of Glasgow north of the River Clyde, population 196,000. SUBJECTS: 3991 men and 1551 women aged 25-64 years on the Glasgow MONICA coronary event register with definite or fatal possible or unclassifiable events according to the criteria of the World Health Organisation's MONICA project (monitoring trends and determinants in cardiovascular disease). MAIN OUTCOME MEASURES: Rate of coronary events; proportion of subjects reaching hospital alive; case fatality in admitted patients and in community overall. RESULTS: Event rates increased with age for both sexes and were greater in men than women at all ages. The rate increased 1.7-fold in men and 2.4-fold in women from the least (Q1) to the most (Q4) deprived socioeconomic quarter. The socioeconomic gradient decreased with age and was steeper for women than men. The proportion treated in hospital (66%) decreased with age, was greater in women than men, and decreased in both sexes with increasing deprivation (age standardised odds ratio 0.82 for Q4 v Q1) Case fatality in hospital (20%) increased with age, was greater for women than men when age was standardised, and showed no strong socioeconomic pattern. Overall case fatality in the community (50%) increased with age, was similar between the sexes, and increased from Q1 to Q4 (age standardised odds ratio 1.12 in men, 1.18 in women). CONCLUSIONS: Socioeconomic group affects not only death rates from myocardial infarction but also event rates and chance of admission. This should be taken into account when different groups of patients are compared. Because social deprivation is associated with so many more deaths outside hospital, primary and secondary prevention are more likely than acute hospital care to reduce the socioeconomic variation in mortality.

Adult↗
PubMed1997

Regrowth resistance as a likely significant contributor to treatment failure in drug-sensitive neoplastic diseases.

Attempts to improve the effectiveness of therapy for neoplastic diseases have largely focused on increasing the cytotoxic efficacy of therapy. While this approach is logical, there is another approach, based on the concept of regrowth resistance, which offers an alternate means of improving treatment outcome. The term "regrowth resistance" refers to the reduction in treatment efficacy resulting from the regrowth of neoplastic cells between courses of therapy or even between doses of radiation therapy. Regrowth resistance is likely to play a significant role in determining the outcome of treatment in rapidly proliferating neoplasms. A reduction in the rate of tumor regrowth would increase the net effectiveness of cytotoxic therapy and would also inhibit the development of resistance to cytotoxic therapies.

Cell Division↗
PubMed1995

Calciphylaxis presenting with calf pain and plaques in four continuous ambulatory peritoneal dialysis patients and in one predialysis patient.

Calciphylaxis is a rare disease associated with hemodialysis or transplantation, high parathyroid hormone values, and increased serum calcium x phosphate (Ca x P) product. Only four patients on continuous ambulatory peritoneal dialysis have been reported with this condition. We report five cases presenting within a 2-year period with severe calf pain and tenderness with extensive nonulcerating large, hard, and tender subcutaneous plaques in the calves. Calcium deposition was confirmed radiologically and by bone scanning. Four patients were on continuous ambulatory peritoneal dialysis, and the other was not yet on dialysis. High serum Ca x P product was found in three of these patients at onset of the condition. Two patients had normal parathyroid hormone levels at onset. Calcium salts and/or calcitriol had been taken prior to onset in three patients. When presenting in this fashion, the diagnosis can be easily made by the uniqueness of the physical findings in the legs. Our observation suggests that the condition should no longer be considered rare and is not confined to hemodialysis patients. Furthermore, it can occur in predialysis patients.

Aged↗
PubMed1992

Immunohistochemical detection of double-stranded-RNA-dependent protein kinase (p68) with a novel monoclonal antibody TJ4C4. A case report of an AIDS-associated Kaposi's sarcoma treated with alpha-interferon.

Double-stranded RNA (dsRNA)-dependent protein kinase (p68) has been shown to be induced by alpha-interferon (IFN-alpha) in mammalian cells. It binds to dsRNA, and is believed to be a factor in the control of both cellular and viral protein synthesis. This report describes the use of a new monoclonal antibody (MAb) TJ4C4, to monitor levels of p68 in a patient with AIDS-associated Kaposi's sarcoma. Using a novel immunoperoxidase/iron staining method, we examined formalin-fixed, paraffin-embedded biopsies prior to, and 4 months after the initiation of IFN therapy. Immunostaining showed low levels (1+ staining) of p68 in the pretreatment tissue, whereas a marked increase (4+ staining) was noted during interferon treatment. This staining suggests an increased level of intracellular p68 expression. This patient has subsequently remained on IFN-alpha therapy and is alive with no evidence of Kaposi's sarcoma, 6 1/2 years after diagnosis. The use of MAb TJ4C4 will greatly facilitate the study of p68 kinase in clinical tissues, and may provide a way to monitor the effects of IFN therapy.

AIDS-Related Opportunistic Infections↗
PubMed1990

Primary hypoadrenalism in a patient with the lupus anticoagulant.

A 68-year-old man known to have the lupus anticoagulant presented with adrenal failure several weeks after undergoing a surgical procedure. Computerized tomography initially showed bilateral enlargement of the adrenal glands, but subsequently demonstrated adrenal atrophy and calcification. It is suggested that thrombosis of the adrenal vessels due to the presence of the lupus anticoagulant may have occurred. In unexplained primary hypoadrenalism with enlargement of the adrenal glands, the presence of the lupus anticoagulant should be excluded.

Adrenal Gland Diseases↗
PubMed1977

Reduced dose of Rho(D) immune globulin following induced first-trimester abortion.

A double-blind study of women after first-trimester abortion supports the efficacy of low-dose Rho(D) immune globulin (human) in the prevention of Rh sensitization. Twenty-seven per cent of patients demonstrated a fetomaternal blood leak based on Kleihauer-Betke stains. In follow-up testing, the percentage of positive titers and the absolute titer of detectable antibody at various intervals were related to the dose of administered immune globulin. This study confirmed the possible risk of sensitization in Rh-negative postabortal women and suggests the practical use of single low-dose immune globulin preparations in prevention.

Abortion, Induced↗
PubMed1976

Antispermatozoal effects of human seminal plasma--an immunologic phenomenon.

Semen samples were obtained from seven men who had self-agglutination of spermatozoa, and a spermatozoal antibody in the immunoglobulin G (IgG) fraction of their blood. The seminal plasma of these men produced spermatozoal immobilization and agglutination when added to normal semen from healthy men. Analysis of the seminal plasma samples showed that they contained IgA and complements C-3 and C-4, whereas only 1 of 10 samples from normal men contained IgA, and none had complements C-3 and C-4. The IgG levels of the seminal plasma from the study group were higher than those of the controls. It is suggested that the mechanism of spermagglutination is one of autooimmunization in which the main antibody is IgA from the genital tract, augmented by a circulating antibody from the IgG fraction of the blood.

Autoantibodies↗
PubMed1976

Antispermatozoal immunoglobulin G in the sera of subfertile men.

Sera were obtained from seven men who had not fathered a child and whose semen showed self-agglutination of spermatozoa. These samples of sera produced considerably more immobilization and agglutination of spermatozoa and positive passive hemagglutination tests than did sera from men whose semen showed less than 10% self-agglutination of spermatozoa.

Autoantibodies↗